Abstract
The aim of this prospective study was to evaluate the results of combined lateral
sagittal resection osteotomy with subtalar distraction fusion in heels with painful
malunion of the os calcis. This case series included 22 patients (23 feet). The mean
age of the patients was 37.52 years. Sixteen (69.6%) patients were initially treated
conservatively, 5 (21.7%) patients were treated surgically, and 2 (8.7%) patients
were missed. The mean time lapsed before surgery was 11.43 months. A wedge of bone
was resected to reduce the width of the malunited os calcis and was used as a local
graft for subtalar joint fusion and to increase the height of the os calcis. The mean
follow-up period was 56.83 ± 6.09 months. According to the scoring system, satisfactory
results were found in 18 (82.6%) patients, and 4 (17.4%) patients had unsatisfactory
results. Postoperative radiographic assessment revealed an average increase in the
heel height of 7.70 ± 1.22 mm and an average decrease in heel width of 8.39 ± 1.47
mm. The average correction in the coronal axis was approximately 8.04° ± 1.26°. Complications
included infection and nonunion in 3 (13%) heels. Two heels still had residual varus
postoperatively, and 1 patient had injury to the sural nerve. The restoration of heel
height, the reduction in heel width, and the primary fracture pattern had a significant
relation with the final score. This method is a successful method for the management
of subtalar arthritis caused by malunited calcaneal fractures with broadening leading
to lateral abutment.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: May 01, 2019
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
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© 2018 by the American College of Foot and Ankle Surgeons. All rights reserved.
